Illness perceptions and coping in physical health conditions: A meta-analysis

Objective: There is a considerable body of research linking elements of Leventhal’s Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature. Methods: A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review. Results: Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent. Conclusions: Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.<br/

Taaperoimetys ja suun terveys

Tämä opinnäytetyö toteutettiin toiminnallisena opinnäytetyönä yhteistyössä Oulun kaupungin suun terveydenhuollon kanssa. Opinnäytetyöksemme valikoitui ajantasaisen oppaan tuottaminen tietolähteeksi taaperoimetyksen, eli 1-2,5-vuotiaan imetyksen, vaikutuksista suun terveyteen kiinnostuneille ja sitä työssään sivuaville. Keväällä 2019 Oulun kaupungin suun terveydenhuollosta ehdotettiin, että laatisimme oppaan heille sähköisessä muodossa, jotta lasten tarkastuksia ja koulutustapahtumia pitävät suuhygienistit ja hammashoitajat voisivat käyttää opastamme koulutusmateriaalina. Tavoitteena oli laatia opas, joka olisi selkeä, asiantuntijatietoon ja tutkimuksiin perustuva, ja jota voisi hyödyntää erilaisissa koulutuksissa ja tapahtumissa. Löysimme aineistoa ajantasaisista tutkimuksista, teoksista ja tietokannoista. Oppaassa kerrotaan, kuinka taaperoimetys toteutuu suun terveyden kannalta parhaalla tavalla. Esittelimme oppaamme sisällön imetyksen moniammatillisin verkoston IMMO-koulutustapahtumassa 12.9.2019. Keräsimme tapahtuman kuuntelijoilta nimettömän palautteen sisällöstä, jotta voisimme muokata sisältöä kaikille ymmärrettävään muotoon. Valmiin oppaan esittelimme Oulun yliopistollisen sairaalan sisäisessä koulutuksessa 3.10.2019. Sähköinen opas on jatkossa Oulun kaupungin suun terveydenhuollon henkilökunnan käytettävissä. Toiminnallisessa opinnäytetyössä työvaiheita olivat projektin aiheen ideointi ja siihen perehtyminen, projektin suunnittelu ja toteutus sekä oppaan luonnostelu, kehittely ja viimeistely, oppaan sisällön esittäminen, palautteen kerääminen oppaasta ja projektin loppuraportin kirjoittaminen. Jatkokehitysideana opinnäytetyömme aiheeseen liittyen voisi olla tietoperustan päivittäminen, jos suosituksiin tulee muutoksia. Aihetta voisi myös laajentaa koskemaan taaperoikäistä vanhemman lapsen imetystä, jos siitä kertyy tutkimustietoa. Tulevaisuudessa IMMO-tapahtumassa voisi myös olla luento aiheesta

Pain Self-Management Behaviors in Breast Cancer Survivors Six Months Post-Primary Treatment: A Mixed-Methods, Descriptive Study

Background/Objectives: One-third of breast cancer (BC) survivors experience chronic treatment-related pain (CTP) that requires multimodal management strategies, which may include pain self-management behaviors (PSMBs). Most studies exploring PSMBs focus on patients with advanced cancer, who may differ from survivors in their pain management needs and access to resources. This mixed-methods study explored PSMBs of survivors of BC, referral sources, and goals for pain relief, and examined the relationship between PSMB engagement and pain intensity/interference. Methods: Survivors of BC who were six months post-treatment completed measures assessing their pain intensity/interference and PSMB engagement. Purposive sampling identified a subset of participants who completed interviews, which were analyzed using thematic analysis. Results: Participants (n = 60) were 60 &plusmn; 10 years old. Worst Pain Intensity and Pain Interference were 3.93 &plusmn; 2.36 and 2.09 &plusmn; 2.11, respectively. Participants engaged in 7 &plusmn; 3.5 PSMBs. The most common were walking (76%) and distraction (76%). PSMBs described in the interviews (n = 10) were arm stretching and strengthening exercises, seeking specialized pain management services, and avoidance. Most PSMBs were self-directed or suggested by friends. All pain relief goals were to minimize pain interference. PSMB engagement was not associated with Worst, Least, or Average Pain Intensity (all rs &le; &minus;0.2, p &ge; 0.05) but was associated with Pain Interference (rs = 0.3, p &le; 0.01). Conclusions: The survivors of BC engaged in many PSMBs, with varying levels of effectiveness and a varying quality of supporting evidence. Most PSMBs were self-directed and some required intervention from healthcare providers or other people, while others required access to limited specialized pain management services

Assessing Social Participation Among Kidney Transplant Recipients Using PROMIS Computer Adaptive Testing

INTRODUCTION: Social participation is a valued aspect of quality of life among kidney transplant recipients; however, few validated measures exist to assess it. This study aimed to explore the reliability and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities (PROMIS-SP), administered as a computer adaptive test (CAT), among kidney transplant recipients.METHODS: This was a cross-sectional study involving a convenience sample of adult recipients from Toronto, Canada. Participants completed the PROMIS-SP CAT and legacy measures of social participation on an electronic data capture platform. Reliability of the PROMIS-SP CAT was determined using standard error of measurement (SEM) and test-retest reliability using intraclass correlation coefficient. Convergent validity was assessed by calculating Spearman's correlation between the PROMIS-SP CAT and legacy measures, and construct validity was assessed using known group comparisons.RESULTS: We recruited 284 participants with a mean (SD) age of 53 (14) years and a median of 5.5 years since kidney transplantation; 61% were male, 53% were White, and 30% had diabetes. The mean (SD) PROMIS T-score was 51 (9). Reliability (r = 0.93) and test-retest reliability (intraclass correlation coefficient = 0.97) of the PROMIS-SP CAT were excellent. Strong correlations were observed between PROMIS-SP CAT and social difficulty inventory (SDI) (rho = -0.65), SDI "everyday living" (rho = -0.68), and EuroQol-5 Dimensions-5 Levels (EQ5D5L) "usual activities" (rho = -0.66). PROMIS-SP CAT scores were significantly different between known groups in the expected direction.CONCLUSION: Our results support the validity and reliability of PROMIS-SP CAT among kidney transplant recipients, and suggest that this tool can be used to identify recipients with restricted social participation.</p

Implementation of self-management support in cancer care and normalization into routine practice: a systematic scoping literature review protocol.

BACKGROUND: Cancer survivors face a myriad of biopsychosocial consequences due to cancer and treatment that may be potentially mitigated through enabling their self-management skills and behaviors for managing illness. Unfortunately, the cancer system lags in its systematic provision of self-management support (SMS) in routine care, and it is unclear what implementation approaches or strategies work to embed SMS in the cancer context to inform health policy and administrator decision-making. METHODS/DESIGN: A comprehensive scoping review study of the literature will be conducted based on methods and steps identified by Arksey and O'Malley and experts in the field. Electronic searches will be conducted in multiple databases including CINAHL, CENTRAL, EMBASE, PsycINFO, MEDLINE, AMED, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE) (up to Issue 2, 2015), ISI Proceedings (Web of Science), PsychAbstracts, and Sociological Abstracts from January 1997 to November 5, 2018. Following the PRISMA-Extension for Scoping Reviews (PRISMA-ScR), two authors will independently screen all titles/abstracts to determine eligibility, data will be abstracted by one author and checked by a second author, and findings will be narratively summarized based on constructs of implementation in the Normalization Process Theory. DISCUSSION: This will be the first scoping review study to synthesize knowledge of implementation of SMS in the cancer care context and the implementation approaches and strategies on embedding in care. This information will be critical to inform health policy and knowledge end users about the necessary changes in care to embed SMS in practices and to stimulate future research

Patient-Perceived Benefits and Limitations of Standard of Care Remote Symptom Monitoring During Cancer Treatment

Introduction Remote symptom monitoring (RSM) allows patients to electronically self-report symptoms to their healthcare team for individual management. Clinical trials have demonstrated overarching benefits; however, little is known regarding patient-perceived benefits and limitations of RSM programs used during patient care. Methods This prospective qualitative study from December 2021 to May 2023 included patients with cancer participating in standard-of-care RSM at the University of Alabama at Birmingham (UAB) in Birmingham, AL, and the Univeristy of South Alabama (USA) Health Mitchell Cancer Institute (MCI) in Mobile, AL. Semi-structured interviews focused on patient experiences with and perceptions surrounding RSM participation. Interviews occurred over the phone, via digital videoconference, or in person, at the convenience of the patient. Grounded theory was used to conduct content coding and identify recurring themes and exemplary quotes using NVivo. Results Forty patients (20 UAB, 20 MCI) were interviewed. Participants were predominately female (87.5%), aged 41-65 (50%), and married (57.5%). Data is consistent with local demographics, comprising mainly White (72.5%) and 27.5% Black individuals. Three main themes emerged regarding perceived benefits of RSM: (1) Facilitation of Proactive Management, identifying the patient’s needs and intervening earlier to alleviate symptom burden; (2) Promotion of Symptom Self-Management, providing patients autonomy in their cancer care; and (3) Improvement in Patient-Healthcare Provider Relationships, fostering genuine connections based on healthcare team’s responses. However, participants also noted Perceived Limitations of RSM; particularly when support of symptom management was unnecessary, ineffective, or felt impersonal. Conclusion This study focused on patient experiences when utilizing a RSM program while undergoing treatment for cancer and found benefits to its implementation that extended beyond symptom management. At the same time, patients noted drawbacks experienced during RSM, which can help with future tailoring of RSM programs. Patient perceptions should be regularly assessed and highlighted for successful and sustained implementation.Plain language summary Cancer and its treatment can cause patients to experience many forms of symptoms. This can have a major effect on their overall well-being: physically, mentally, and emotionally. Early symptom detection and management has been shown to significantly improve the quality of life of patients with cancer. Remote symptom monitoring (RSM) allow patients to report their symptoms to their healthcare team and receive personalized feedback and management from them, without having to leave the comfort of their home. Although previous studies have shown the overarching benefits of implementing RSM during care, little is known regarding how patients perceive its implementation. This research team wanted to gain a better understanding of perceptions patients had, whether good or bad, of RSM’s implementation while they were actively undergoing cancer care. A total of 40 patients were interviewed with patients commenting on RSM’s ability to facilitate proactive management, promote symptom self-management, and improve patient-healthcare provider relationships. Patients also had feelings that under certain circumstances, RSM did have some limitations. This study was able to help identify some of the perceived benefits and limitations to RSM implementation. This feedback will not only help to ensure the successful implementation of future RSM programs but will also let patients know that they are heard and that their feedback is pivotal

Developing an evidence-based fall prevention curriculum for community health workers

This perspective paper describes processes in the development of an evidence-based fall prevention curriculum for community health workers/promotores (CHW/P) that highlights the development of the curriculum and addresses: (1) the need and rationale for involving CHW/P in fall prevention; (2) involvement of CHW/P and content experts in the curriculum development; (3) best practices utilized in the curriculum development and training implementation; and (4) next steps for dissemination and utilization of the CHW/P fall prevention curriculum. The project team of CHW/P and content experts developed, pilot tested, and revised bilingual in-person training modules about fall prevention among older adults. The curriculum incorporated the following major themes: (1) fall risk factors and strategies to reduce/prevent falls; (2) communication strategies to reduce risk of falling and strategies for developing fall prevention plans; and (3) health behavior change theories utilized to prevent and reduce falls. Three separate fall prevention modules were developed for CHW/P and CHW/P Instructors to be used during in-person trainings. Module development incorporated a five-step process: (1) conduct informal focus groups with CHW/P to inform content development; (2) develop three in-person modules in English and Spanish with input from content experts; (3) pilot-test the modules with CHW/P; (4) refine and finalize modules based on pilot-test feedback; and (5) submit modules for approval of continuing education units. This project contributes to the existing evidence-based literature by examining the role of CHW/P in fall prevention among older adults. By including evidence-based communication strategies such as message tailoring, the curriculum design allows CHW/P to personalize the information for individuals, which can result in an effective dissemination of a curriculum that is evidence-based and culturally appropriate.U48 DP001924 - NCCDPHP CDC HHS; U48 DP001944 - NCCDPHP CDC HHSPublished versio

Manual lymphatic drainage for lymphedema following breast cancer treatment

Background More than one in five of breast cancer patients will develop breast cancer-related lymphedema (BCRL). BCRL is a swelling that can occur in the arm, breast, or chest wall as a result of breast cancer surgery and/or radiation therapy. BCRL can negatively impact comfort, function, and quality of life Manual lymphatic drainage (MLD) is a hands-on therapy that is commonly used for BCRL and often as part of complex decongestive therapy (CDT). CDT consists of MLD, compression bandaging, lymph-reducing exercises (LREs), and skin care. The Review Questions Is MLD safe and effective in treating BCRL? Study Characteristics We found six trials published through May, 2013, totaling 208 participants. Key Results When women were treated with a course of intensive compression bandaging, their swelling went down about 30% to 37%. When MLD was added to the intensive course of compression bandaging, their swelling went down another 7.11%. Thus, MLD may offer benefit when added to compression bandaging. Examining this finding more closely showed that this significant reduction benefit was observed in people with mild-to-moderate lymphedema when compared to participants with moderate-to-severe lymphedema. Thus, our findings suggest that individuals with mild-to-moderate BCRL are the ones who may benefit from adding MLD to an intensive course of treatment with compression bandaging. This finding, however, needs to be confirmed by further research. When women were given a standard elastic compression sleeve plus MLD and compared to women who received a standard compression sleeve plus a nonMLD treatment, results were mixed (sometimes favoring MLD and sometimes favoring neither treatment.) One-year follow-up suggests that once swelling had been reduced, participants were likely to keep their swelling down if they continued to use a custom-made sleeve. MLD is safe and well tolerated. Findings were contradictory for function (range of motion), with one trial showing benefit and the other not. Two trials measured quality of life, but neither trial presented results comparing the treatment group to the control, so findings are inconclusive. No trial measured cost of care. Quality of the Evidence Trials were small ranging from 24 to 45 participants. Most trials appeared to randomize participants adequately. However, in four trials the person measuring the swelling knew what treatment the participants were receiving, and this could have biased results. Authors' conclusions: MLD is safe and may offer additional benefit to compression bandaging for swelling reduction. Compared to individuals with moderate-to-severe BCRL, those with mild-to-moderate BCRL may be the ones who benefit from adding MLD to an intensive course of treatment with compression bandaging. This finding, however, needs to be confirmed by randomized data. In trials where MLD and sleeve were compared with a nonMLD treatment and sleeve, volumetric outcomes were inconsistent within the same trial. Research is needed to identify the most clinically meaningful volumetric measurement, to incorporate newer technologies in LE assessment, and to assess other clinically relevant outcomes such as fibrotic tissue formation. Findings were contradictory for function (range of motion), and inconclusive for quality of life. For symptoms such as pain and heaviness, 60% to 80% of participants reported feeling better regardless of which treatment they received. One-year follow-up suggests that once swelling had been reduced, participants were likely to keep their swelling down if they continued to use a custom-made sleeve.sch_nurpub4539pu